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Tackling bone loss of the lower extremity:vascularized bone grafting

Plastic and Aesthetic Research 2022年第1期9卷 254-263页

作者： Christine V.Schaeffer John T.Stranix Department of Plastic and Reconstructive Surgery The University of VirginiaCharlottesvilleVA 22903USA

Post-traumatic lower extremity bone loss in the setting of high-energy trauma can occur acutely as a result of an open fracture and surgical debridement,or secondarily as a result of nonunion or *** techniques have been described in the literature for the management of these bony defects,including non-vascularized bone grafts,vascularized bone grafts and distraction ***,the authors review the role of vascularized bone grafts in the management of post-traumatic bone loss in the lower extremity.

关键词： Lower extremity vascularized bone segmental defect

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Reconstruction of extremity long bone defects with vascularized fibula bone grafts

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Plastic and Aesthetic Research 2019年第6期6卷 1-12页

作者： Corinne Wee DanieI Ruter Steven SchuIz Geoffroy Sisk JuIie West Scott TintIe Ian VaIerio Division of Plastic and Reconstructive Surgery in the Department of Surgery Case Western Reserve UniversityClevelandOH 44106USA Division of Plastic and Reconstructive Surgery in the Department of Surgery Albany Medical CollegeAlbanyNY 12208USA Department of Plastic and Reconstructive Surgery The Ohio State UniversityColumbusOH 43212USA Department of Orthopaedic Surgery Walter Reed National Military Medical CenterBethesdaMD 20889USA

Aim: Composite tissue defects encompassing bone and/or isolated bony defects can pose a surgical challenge;however, their reconstruction is critical for successful functional limb salvage. These cases become increasingly problematic as secondary defects, following multiple nonvascularized grafting attempts resulting in complex bony nonunion. Herein, our experience utilizing fibula vascularized bone grafts (VBGs) for bone restoration will be presented to demonstrate their utility in a variety of reconstructions for limb salvage. Methods: This is a case series describing a series of vascularized fibula grafts for extremity reconstruction performed by a single academic surgeon over multiple institutions in seven years. Results: Twenty-seven (27) total VBGs met inclusion criteria and underwent reconstruction for traumatic (16), oncologic (6) and chronic degenerative (5) etiologies. Bony union was achieved in 26 of 27 cases. Conclusion: The decision-making process for bony reconstruction in these scenarios is difficult and multivariable. Fibula VBGs can provide a single-stage solution for autologous bony and soft tissue replacement of large or complex bone defects and can often be superior options compared with non-vascularized bone grafts or non-bone internal fixation techniques. Their osteogenic potential is unmatched by allogenic or synthetic substitutions. These benefits are evident in a variety of clinical settings such as pediatrics, oncology and trauma.

关键词： vascularized bone vascularized bone grafts composite extremity defect restoration bone reconstruction free tissue transfer microsurgery

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